Supraglottic Carcinoma in Intravenous Opioid Drug Abusers: A Distinct Disease with Improved Survival
Dan Yaniv MD
Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
Department of Otorhinolaryngology and Head and Neck Surgery, Rabin Medical Center, Petah Tikva, Israel
Search for more papers by this authorYonatan Reuven MD, PhD
Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
Department of Otorhinolaryngology and Head and Neck Surgery, Rabin Medical Center, Petah Tikva, Israel
Search for more papers by this authorYonatan Lahav MD
Department of Otolaryngology, Head and Neck Surgery, Kaplan Medical Center, Rehovot, Israel
Hebrew University and Hadassah Medical School, Jerusalem, Israel
Search for more papers by this authorOded Cohen MD
Department of Otolaryngology, Head and Neck Surgery, Kaplan Medical Center, Rehovot, Israel
Hebrew University and Hadassah Medical School, Jerusalem, Israel
Search for more papers by this authorYaniv Hamzany MD
Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
Department of Otorhinolaryngology and Head and Neck Surgery, Rabin Medical Center, Petah Tikva, Israel
Search for more papers by this authorAssaf Moore MD
Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
Davidoff Cancer Center, Rabin Medical Center, Beilinson Hospital, Petah Tikva, Israel
Search for more papers by this authorOlga G. Rapana MD
Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
Search for more papers by this authorNatan Argaman MD
Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
Search for more papers by this authorDoron Halperin MD
Department of Otolaryngology, Head and Neck Surgery, Kaplan Medical Center, Rehovot, Israel
Hebrew University and Hadassah Medical School, Jerusalem, Israel
Search for more papers by this authorAron Popovtzer MD
Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
Davidoff Cancer Center, Rabin Medical Center, Beilinson Hospital, Petah Tikva, Israel
Search for more papers by this authorGideon Bachar MD
Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
Department of Otorhinolaryngology and Head and Neck Surgery, Rabin Medical Center, Petah Tikva, Israel
Search for more papers by this authorCorresponding Author
Hagit Shoffel-Havakuk MD
Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
Department of Otorhinolaryngology and Head and Neck Surgery, Rabin Medical Center, Petah Tikva, Israel
Send correspondence to Hagit Shoffel-Havakuk, MD, Sackler School of Medicine, Tel Aviv University Department of Otolaryngology Head and Neck Surgery Rabin Medical Center 39 Ze'ev Jabotinsky Street, Petah Tikva, Israel. E-mail: [email protected]
Search for more papers by this authorDan Yaniv MD
Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
Department of Otorhinolaryngology and Head and Neck Surgery, Rabin Medical Center, Petah Tikva, Israel
Search for more papers by this authorYonatan Reuven MD, PhD
Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
Department of Otorhinolaryngology and Head and Neck Surgery, Rabin Medical Center, Petah Tikva, Israel
Search for more papers by this authorYonatan Lahav MD
Department of Otolaryngology, Head and Neck Surgery, Kaplan Medical Center, Rehovot, Israel
Hebrew University and Hadassah Medical School, Jerusalem, Israel
Search for more papers by this authorOded Cohen MD
Department of Otolaryngology, Head and Neck Surgery, Kaplan Medical Center, Rehovot, Israel
Hebrew University and Hadassah Medical School, Jerusalem, Israel
Search for more papers by this authorYaniv Hamzany MD
Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
Department of Otorhinolaryngology and Head and Neck Surgery, Rabin Medical Center, Petah Tikva, Israel
Search for more papers by this authorAssaf Moore MD
Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
Davidoff Cancer Center, Rabin Medical Center, Beilinson Hospital, Petah Tikva, Israel
Search for more papers by this authorOlga G. Rapana MD
Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
Search for more papers by this authorNatan Argaman MD
Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
Search for more papers by this authorDoron Halperin MD
Department of Otolaryngology, Head and Neck Surgery, Kaplan Medical Center, Rehovot, Israel
Hebrew University and Hadassah Medical School, Jerusalem, Israel
Search for more papers by this authorAron Popovtzer MD
Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
Davidoff Cancer Center, Rabin Medical Center, Beilinson Hospital, Petah Tikva, Israel
Search for more papers by this authorGideon Bachar MD
Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
Department of Otorhinolaryngology and Head and Neck Surgery, Rabin Medical Center, Petah Tikva, Israel
Search for more papers by this authorCorresponding Author
Hagit Shoffel-Havakuk MD
Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
Department of Otorhinolaryngology and Head and Neck Surgery, Rabin Medical Center, Petah Tikva, Israel
Send correspondence to Hagit Shoffel-Havakuk, MD, Sackler School of Medicine, Tel Aviv University Department of Otolaryngology Head and Neck Surgery Rabin Medical Center 39 Ze'ev Jabotinsky Street, Petah Tikva, Israel. E-mail: [email protected]
Search for more papers by this authorEditor's Note: This Manuscript was accepted for publication on August 11, 2020.
d.y. and y.r. contributed equally to the study.
The authors have no funding, financial relationships, or conflicts of interest to disclose.
Abstract
Objectives/Hypothesis
Recent evidence indicates an increased prevalence of intravenous opioid drug abusers (IVDAs) among supraglottic squamous cell carcinoma (SG-SCC) patients. This study investigates whether the clinical course of SG-SCC in IVDA differs from SG-SCC in non-IVDA.
Study Design
A retrospective case–control study conducted in a in two tertiary referral centers.
Methods
This case–control study compares IVDA with non-IVDA patients diagnosed and treated for SG-SCC in between 2005 and 2018. Disease-free survival (DFS) and overall survival (OS) were calculated using the Kaplan–Meier estimator. Adjusted odds ratios (ORs) for mortality were calculated using multivariant analyses.
Results
A total of 124 patients were included; 21% (26) were IVDA, and 79% (98) were non-IVDA. Age at diagnosis in the IVDA group versus the non-IVDA group was 53 and 66 years, respectively (P = .001). Nevertheless, the age hazard ratio for OS was calculated and found to have minimal to no effect, 1.05 (95% Cl: 1.025–1.076). Otherwise, the two groups were comparable regarding demographics, other risk factors (i.e., gender, smoking, and alcohol), and comorbidities status, as well as the comparable stage at diagnosis, histologic grading, and treatment modalities. Although the DFS was comparable in both groups, the 5-year OS was 55% in the IVDA group compared with 34% among the non-IVDA patients (P = .04). In multivariant analyses for mortality, positive IVDA history was found to be protective, adjusted OR: 0.263 (95% CI: 0.081–0.854). Similarly, within the subgroup of 100 patients with advanced-stage disease (III and IV), the adjusted OR was 0.118 (95% CI: 0.028–0.495).
Conclusions
SG-SCC in IVDA patients has a distinct clinical course, presenting at a younger age, and may have improved prognosis.
Level of Evidence
NA Laryngoscope, 131:E1190–E1197, 2021
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